膈肌起搏器应用于长期卧床的急性加重期COPD患者的临床效果分析

Clinical Effect Analysis of Diaphragm Pacemaker in Long-Term Bedridden Patients with Acute Exacerbation of COPD

目的分析膈肌起搏器应用于长期卧床的急性加重期COPD患者的临床疗效.方法选取2020年8月—2021年12月于我院治疗的80例长期卧床的急性加重期慢性阻塞性肺疾病(COPD)患者,按随机数字表法将患者分为两组,各40例.对照组采用呼吸功能训练,观察组在对照组基础上采用膈肌起搏器.比较两组患者肺功能、血气分析指标及膈肌功能.结果观察组第1秒用力呼气容积(FEV_(1))、用力肺活量均大于对照组,FEV_(1)占预计值的百分比高于对照组,组间差异有统计学意义(P<0.05).观察组动脉血氧分压、动脉血氧饱和度均高于对照组,动脉血二氧化碳分压低于对照组,组间差异有统计学意义(P<0.05).观察组最大吸气腹压高于对照组,呼气末膈肌厚度、吸气末膈肌厚度均厚于对照组,膈肌活动度大于对照组,组间差异有统计学意义(P<0.05).结论膈肌起搏器应用于长期卧床的急性加重期COPD患者效果较好,增强膈肌功能的同时还能改善患者肺功能和血气分析指标水平,值得临床推广应用.

Objective To analyze the clinical efficacy of diaphragm pacemaker in long-term bedridden patients with acute exacerbation of COPD.Methods 80 long-term bedridden patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)were treated in our hospital from August 2020 to December 2021 were selected and divided into two groups according to the random number table method,with 40 cases in each group.The control group was given respiratory function training,and the observation group was given diaphragm pacemaker on the basis of the control group.The pulmonary function,blood gas analysis indexes and diaphragm function were compared between the two groups.Results The forced expiratory volume in one second(FEV_(1))and forced vital capacity in the observation group were greater than those in the control group,FEV_(1)as a percentage of expected value was higher than that in the control group,and the differences between the groups were statistically significant(P<0.05).The arterial oxygen partial pressure and arterial oxygen saturation in the observation group were higher than those in the control group,and arterial carbon dioxide partial pressure in the arterial blood was lower than that in the control group,and the differences between the groups were statistically significant(P<0.05).The maximum inspiratory abdominal pressure of the observation group was higher than that of the control group,the end expiratory diaphragm thickness and end inspiratory diaphragm thickness were thicker than those of the control group,and the diaphragm activity was greater than that of the control group,and the differences between the groups were statistically significant(P<0.05).Conclusion The diaphragm pacemaker is effective in long-term bedridden patients with acute exacerbation of COPD.It can enhance the diaphragm function and improve the pulmonary function and blood gas analysis indexes level of patients at the same time,which is worthy of clinical promotion and application.